For Patients Who Are
Considering Proton Therapy
Proton Beam Therapy Center
University of Tsukuba Hospital1

Contents
03
The University of Tsukuba:
Pioneer of a worldwide standard in proton therapy

04
What is proton therapy?

06
For non-Japanese patients:
Arranging to receive proton therapy

07

1

The stages of pre-treatment preparation

2

08
During and after treatment

09
Therapy equipment created through collaboration
between the fields of medical science and physics

10

3

The main conditions treated with proton therapy

1. Prof. Hideyuki Sakurai, Director of the Proton Beam
Therapy Center (left), Prof. Takeji Sakae, Head of
the Medical Physics Group (center), and Koji Tsuboi,
Director of the Proton Medical Research Center (right)
2. The Proton Beam Therapy Center is part of the
University of Tsukuba Hospital, which aims toprovide effective patient-centered care through thecollaboration of teams of medical practitioners.
3. The team of doctors who provide proton therapy,
striving to ensure that patients receive the best
possible treatment while also maintaining a goodquality of life
4. The team of medical physicists who engage in
research in radiation physics to develop proton
therapy which is safe and minimizes the physical side
effects on the patient
02

4

University of Tsukuba:
Pioneer of a worldwide
standard in proton therapy

History
1973

1975

University of Tsukuba began full-scale clinical research inproton therapy in 1983, as the first facility in Japan topursue research in the field. The university has achieved
a number of significant developments in the field, inparticular internationally pioneering the use of proton
therapy to treat cancerous liver tumors and other tumors
deep inside the body by developing the treatment method
known as respiratory-gated radiotherapy, which is now
highly regarded and considered as a worldwide standard in
proton therapy.
A significant characteristic of proton therapy is that the
proton-beam can be targeted at a tumor with pinpoint
precision such that the healthy cells surrounding it areleft undamaged and only mild side effects are produced.
As this therapy minimizes the physical side effects on thepatient, it can be a highly effective means of treating aged
or frail cancer patients with complications such as a heartdisease. Proton therapy is also a good method for treatingand helping to ensure a healthy future for children or
young cancer patients, because the risks that it will inhibit
their physical growth and development or cause secondary
cancer are low.
As the Proton Beam Therapy Center is part of the Universityof Tsukuba Hospital, the center staff are able to cooperate
closely with doctors and medical practitioners specializing
in internal medicine, surgery, and a number of otherfields, working in teams and adopting a multidisciplinary
perspective in order to provide the best possible therapy.
There is no universal method of treating cancer and eachpatient needs to receive treatment that has been adapted totheir individual condition. We place the utmost importanceon providing the most suitable means of treatment for eachpatient by carefully examining their physical and mental
condition, such as their symptoms, age, physical strength,
or ways of thinking about medical treatment.

1976

1977
1979
1982
1983
1990
2001

2004

2008
2014

National Laboratory for High Energy Physics (KEK)—
currently the High-Energy Accelerator Research
Organization—proposes particle therapy using a largescale proton accelerator.
KEK, the National Institute of Radiological Sciences, andthe University of Tsukuba agree to implement a particle
therapy project.
The “Working Group for Research in Medical andBiological Use of High LET Particles” is established at
the University of Tsukuba. The group is renamed the“Preparatory Committee for the Committee for Study ofBiological and Chemical Use of High-LET Radiation” inDecember, and the particle therapy project is developed
as a university-wide initiative.
A joint experiment using a large-scale proton accelerator
commences.
The project organization is renamed the Particle Medical
Center, with the project duration set as ten years.
A proton facility is built, and work is commenced on
proton experiments on living creatures.
The world’s first clinical study using a vertical beam
begins.
The Particle Medical Center reaches the end of its tenyear duration, and the Proton Medical Use ResearchCenter is established in its place.
A new facility is built at the University of Tsukuba
Hospital and becomes the new location of the Proton
Medical Use Research Center.
The Proton Medical Use Research Center is made anaffiliated organization of the hospital following thereorganization of the university as a national university
corporation
Proton therapy is recognized as an advanced medical
treatment.
The Proton Beam Therapy Center is established as aclinical department.

Cancer treatments today generally adopt a combinationof methods such as surgery, chemotherapy, and radiation
treatment, utilizing the elements of each method which
are most suited to treating the patient’s condition. Proton
therapy can be used as part of such combined treatment
methods to ensure that patients maintain a good quality oflife.
Through our clinical practice and research, we strive toassist a greater number of patients by providing anddeveloping proton therapy. If you are considering proton
therapy as a treatment option, please do not hesitate toconsult with us.
Hideyuki Sakurai
Director, Proton Beam Therapy Center,
University of Tsukuba Hospital

Treatment results:

As of March 2016, the Proton Beam Therapy Center has treated
4,605 patients, including those treated by the National
Laboratory for High Energy Physics (KEK)—currently known as
the High-Energy Accelerator Research Organization—between
1983 and 2000.
The largest portion of cases treated were cases of liver cancer,
followed by prostate cancer and lung cancer.
Our center provides proton therapy for any condition inwhich the therapy can be effectively applied to the tumor.

03

What is proton therapy?

1

Proton therapy is a type of radiation therapy
The three main types of cancer treatment are:

Radiationtherapysurgery, chemotherapy, andradiation therapy.
Proton therapy is a type of radiation therapy which isrecognized as an advanced medical treatment.
While traditional radiation therapies use photonrays such as X-rays and γ-rays, proton therapy uses
a proton beam made by accelerating the nuclei ofhydrogen atoms (protons) to increase their energy.
Proton therapy has been attracting attention in recent
years due to the fact that the physical properties of a
proton beam allow for highly effective treatment with
only mild physical side effects on the patient.

Traditional methodsof therapy

Particle therapy

Protontherapy

X-rays therapy,
γ-rays therapy

Heavy
particletherapy

The proton beam can be directed at a tumor
with pinpoint precision
In traditional radiation therapy, a radiation ray beamsuch as an X-ray beam releases its maximum energy
dose close to the surface of the body and continues
to release an energy dose which declines as it travels
deeper into the body. As the beam continues beyond
the tumor, depositing energy as it passes throughthe body, it unavoidably damages healthy tissue ororgans behind the tumor.
By contrast, in proton therapy the physical propertiesof the proton beam allow it to release its maximum
energy dose at a set depth inside the body and end
there. Therefore, if the proton beam is adjusted to thedepth of the tumor, the beam releases the maximum
energy dose when it arrives at the tumor, and ends
there without travelling any farther.
By planning the optimal therapy for each individual
patient, the proton beam can be used to effectively
destroy the tumor with pinpoint accuracy while
producing only a small effect on the surrounding
healthy tissue.

100
Relative dose (%)

2

New methodsof therapy

X-ray beam

75
50

Proton beam
25
0

2

4

6

8

10

12

14

16

18

Depth (cm)Spread of tumor
The point where a proton beam releases its maximum energy
dose is called the “Bragg peak.” In proton therapy, this Bragg
peak is set to match the location and size of the tumor.
Proton therapy is highly effective as it allows the energy
dose released by an emitted beam to be more accurately
concentrated on a tumor than is possible in traditionalradiation therapy.

04

20

Illustrations of X-ray and proton beams inside the body
In traditional X-ray therapy, the beam goes past thetumor. It therefore delivers radiation not only to thetumor but also to other organs such as the heart
and lung. In proton therapy, if the Bragg peak is set
at the tumor, the beam ends there, therefore having
less effect on healthy organs around the tumor.

Proton therapy
Proton beam
Bolus

Traditional radiation therapy

X-ray beam
Organ for which no
therapy is necessary

Collimator

Heart

Heart

Proton beam
X-ray beam
Cancerous tumor
Cancerous tumor

Lung

3

Spinal
cord

Lung

Lung

Spinal cord

Lung

Proton therapy has limited physical side effects
and helps ensure a good quality of life
Proton therapy allows for cancer cells to be accurately targeted, causingmuch less damage to other healthy cells. In comparison with traditionalradiation therapy, it produces milder side effects, resulting in only asmall physical burden on the patient. The patient therefore has little
trouble returning to his or her everyday life and maintaining a goodquality of life. As a general rule, patients receiving proton therapy aretreated as outpatients and do not need to be hospitalized.

Quality of LifeThe benefits of proton therapy
nnThe proton beam can be delivered directly to thetumor with high amounts of energy and precision,
resulting in highly effective treatment.
nnIt can be accurately targeted at a tumor, minimizing
the side effects on organs susceptible to the effectsof radiation.
nnIt can be used for the treatment of aged and frail
patients due its reduced physical side effects.

nnThe risks of secondary cancer in children or young people
are low.
nnIt can also be used to treat cancer patients who havecomplications and are unable to undergo surgery.
nnPatients can visit the hospital for daily treatment as
outpatients and do not need to be hospitalized.
nnPatients are likely to have less difficulty returning to daily
life in society, and can maintain a good quality of life.

Side effects of proton therapy
While proton therapy minimizes the effects on healthy tissues and organs and therefore
causes relatively fewer physical side effects than traditional radiation therapy, it may produce
some side effects. For example, in some cases patients develop sunburn-like symptoms on
the skin of the part of the body which the proton beams were directed at. The side effects
of proton therapy may differ according to the part of the body in which the tumor is locatedand the angle of the proton beam. A specialist will explain such side effects in detail if you areconsidering receiving proton therapy, and it is important to ensure that you understand thepossible side effects before deciding to proceed with the therapy.

05

For non-Japanese patients:

Arranging to receive proton therapy
If you would like to receive proton therapy,
please follow these steps:
Step

1

Fill in all of the required items on the inquiry formand send by email to:

proton_therapy@pmrc.tsukuba.ac.jp
The inquiry form can be downloaded at:

http://www.pmrc.tsukuba.ac.jp

Step

2

A doctor at the Proton
Beam Therapy Center will
send you a reply regarding
the possibilities for you toreceive proton therapy.
(This step is free of charge).

If a more detailed imaging diagnosis is required, you are requested to use a support service
provided by Emergency Assistance Japan (EAJ), which is a medical coordination service
company designated by the University of Tsukuba Hospital (This step is not free of charge).

2 EAJ makes a request for

1 You send medical

imaging diagnosis and pays
the diagnosis fee to theProton Beam Therapy Center

examination images andpayment for the diagnosis
fee to EAJ

4 Reply
Patient

Contact:

3 Diagnosis results

Emergency Assistance Japan (EAJ)

Proton Beam Therapy Center

Emergency Assistance Japan+81-3-3811-8600

NRK Koishikawa Bldg.,
1-21-14 Koishikawa, Bunkyo-ku,
Tokyo, JAPAN 112-0002+81-3-3811-8271+81-3-3811-8251[English and Japanese][Russian][Chinese]

If it is not possible to make a diagnosis based on the images and/or medical information you provide, you may be requested to takeanother medical examination (the same applies when visiting the hospital directly for diagnosis).

When you consult with us about
proton therapy
We always use a support service and a medical interpreter
arranged by EAJ.

This is to ensure that you are able to understand the method oftreatment well and receive treatment with peace of mind, freefrom concerns that might arise from factors such as the unfamiliar
language, medical care customs, or living environment.

We are not able to assist in arranging visas or
accommodation which you may require in order to receive
proton therapy at our center.
Please consult with EAJ for assistance with immigration
requirements, living arrangements, or other such matters.

06

After receiving proton therapy
We request that communication with the Proton
Beam Therapy Center after your treatment iscomplete is carried out through your local doctor.

You (patient) Þ Your local doctor ÞProton Beam Therapy CenterIf you would like our medical follow-up service,please contact EAJ.

You (patient) Þ EAJ Þ
Proton Beam Therapy Center

The stages of pre-treatment preparation
Below is a general overview of the stages of proton therapy.
It is necessary to ensure that treatment is suited to each individual
patient, by devising treatment plans and creating immobilizationand treatment devices to help you to remain still during treatment
and ensure that the proton beam is administered accurately.

1

To start of proton
therapy treatment

Initial visit and medical
examination

We ascertain the condition of the tumor and your overall
physical condition by performing a physical examinationand checking the referral and the medical image data
which you bring to the first visit. We consider whether
proton therapy is appropriate for you on the basis of acomprehensive assessment of your condition.
On your first visit, we arrange for medical examinations
and tests as necessary.
We begin preparations for treatment after it is determinedthat proton therapy is the most suitable treatment for you.

We aim to ensure that treatment is highly accurate and minimizes thephysical side effects on the patient.

2-5 Measuring the proton beam dose
We set-up the collimator and bolus in the dedicated proton
beam equipment, emit a proton beam and measure its
dose and distribution. Once it has been confirmed that thedose measured matches the treatment plan, the actual
administration of proton therapy is begun.

2-4 Creating treatment devices

A doctor carefully explains
the patient’s symptoms andtreatments.

2

We make two devices—called a collimator and a bolus—
each with the same shape as your tumor in order to ensurethat the shape and depth of a proton beam matches thetumor.

About seven to ten days of
preparations before treatment
is started

2-1 Creating immobilization device
An immobilization device is custom made to fit your body
shape, in order to help you to remain still during treatment
and ensure that the proton beam is always targeting thecorrect area.

2-2 CT imaging of your body in theimmobilization device
CT images of your body in the immobilization device aretaken for use in the planning of treatment.

All the doctors take part in a meeting
every morning.

Medical physicists check treatment plans in
the treatment planning room.

2-3 Developing a treatment plan
We make a concrete and detailed proton-dosing plan, by
calculating the suitable angle, depth, dose, and frequency
at which to administer the proton beam according to your
medical condition. The doctor in charge of your treatment
and other medical staff including doctors, medical
physicists, radiological technicians, and nurses meet atregularly intervals to share information on the treatment
plan and progress of treatment.

Preparation period before
the start of treatment07During and after treatment
Once all of the preparatory stages have been completed, your treatment will begin.
During the treatment period, you visit the Proton Beam Therapy Center to receive treatment every
weekday.*1
The number of times and the period for which treatment is administered vary according to the
medical condition of the patient.
*1 Except for maintenance days and public holidays.

Checking the correct positioning of the
proton-beam X-ray imaging
We take X-ray images of you in two directions to check thepositioning of the proton-beam and ensure that it targets
the tumor exactly.

Setting two important devices in theemission port to improve the precisionof proton beam emission
We install two devices on the tip of the emission port: acollimator (right), which shapes the contours of the proton
beam to fit the tumor and a bolus (left), which sets the beamat the depth of the tumor.
These devices are remodeled each time the size of the tumor
is reduced.

The respiratory-gating system—
pioneered by the University ofTsukuba—ensures that the proton beam
accurately targets the tumor

A bolus (left) and a collimator(right) are custom-made foreach patient so as to fit the sizeand depth of his or her tumor. If
a proton beam is administeredfrom different angles, a bolus
and a collimator are made to fit
each angle.

As a person breathes, their diaphragm moves up and down
three to four centimeters, moving the liver and lungs up anddown. The University of Tsukuba has developed a method
known as respiratory-gating which ensures that the proton
beam equipment is not affected by such movement andtargets the same point every time. A laser sensor placed on
the abdomen of the patient senses the movement of the
body and a proton beam is emitted only when it is in thecorrect position.

Each treatment session lasts 15-30 minutes
You will not feel pain while you are treated with the protonbeam. The administration of the proton-beam only takes one
to three minutes each time. However, a session of treatment
takes 15-30 minutes in total as it includes other steps, suchas checking the position of the beam.

Follow-up after treatment

The patient lies in an immobilization device
which has been custom-made to the shapeof the patient’s body to help him/her keep
still while receiving proton therapy.
(The patient may also have to wear animmobilization device for his or her head).

08

After proton therapy is complete, we provide a
medical follow-up service in cooperation withthe doctor who initially referred the patient to us.
Patients visit our Outpatient section once every
three months for consultations regarding the
progress of their condition the results of medical
examinations under the referring doctor’s medicalcare. We continue to observe the progress of apatient’s condition for five years after the proton
therapy treatment, giving necessary advice to him
or her from the viewpoint of a proton therapy
specialist. We provide consultations or respond toinquiry any time after the treatment as requested.

Therapy equipment created through collaboration
between the fields of medical science and physics
Producing a proton beam for use in proton therapy requires the use of
massive equipment composed of various components.
The following images provide rare glimpses of the proton-beam equipment.

LINAC

Synchrotron

The LINAC is the first component to accelerate
the protons. The protons accelerated by the
LINAC go into a type of accelerator known as a“synchrotron.”

The synchrotron further accelerates the protons
on a circular orbit up to 60% of light speed. The
synchrotron is about seven meters in diameter.
When protons are accelerated to such a speed,
they can reach more than 30 cm deep in thehuman body. A proton beam at such a particle
speed can therefore be used for treating
patients with larger bodies.

Rotating gantry

The accelerator control room formonitoring the stable supply of
protons

The rotating gantry is a drum-shaped apparatus
which is 10 m high and weighs 200 tons. It
contains an emission port and is connected tothe proton therapy treatment room.
Rotating the gantry rotates the emission port
360 degrees around the treatment bed.
Our center is equipped with two such gantries.

The accelerator control room constantly
monitors the equipment described here toensure that the protons they create are stably
supplied.

PersonLook how huge the equipment is in comparison
with a person!

09

The main conditions treated with
proton therapy
Proton therapy is an effective option for treating cancer because it provides highly effective treatment while causing
only mild physical side effects. At the same time, not all forms of cancer can be treated using proton therapy.
Please note that proton therapy can only be administered if all of the basic conditions described below apply.
A specialist at this center will diagnose whether or not your condition is suited to receiving proton therapy on thebasis of a comprehensive overview.
If alternative treatments are more suitable for you due to the type and conditions of your disease, we will consult
with specialists in the relevant field at our hospital to propose such treatments.

Basic conditions
nnThe tumor has not spread to any other organ in the body, andis limited to a small area.

nnThe patient can lie still in the same position for 30
minutes.

nnThe patient has not already received radiation therapy on thepart of the body where the proton therapy is to be applied.

nnThe patient has been informed about his or her disease,and he or she wishes to receive proton therapy.

Liver cancer
In most cases of liver cancer (hepatocellular carcinoma), theonset of the disease occurs after suffering from cirrhosis
caused by chronic hepatitis B or C. As proton therapy allows
the radiation beam to be focused on the tumor, it causes
significantly less damage to the healthy portions of the liverand is therefore much less likely to cause a decline in liverfunction.
In most cases, the liver itself is susceptible to cancer due
to being affected by hepatitis and cirrhosis for a number ofyears and may have other tumors.
It is therefore necessary for a specialist to monitor thepatient’s condition following treatment.

Prostate cancer
The treatments for prostate cancer include surgery, radiation
therapy, and hormone therapy. Treatment methods are
decided on the basis of the results of blood tests, imaging
examinations, and pathological examinations. Proton
therapy is one of the most effective and safest treatments
among the treatments using radiation. Proton therapy
treatment methods can be arranged promptly if the patient
first consults with his or her urology doctor about cancer
treatments and brings the examination results (in particular,a biopsy tissue sample) to the initial proton therapy
consultation.

Lung cancer
There are a number of types of lung cancer which differ
according to the form of the cancer cells. Patients with casesof stage I lung cancer, in which cancer cells are localized ina lung, may be treated using proton therapy as outpatientsfor a period of about two weeks. In cases of stage II and III
lung cancer, in which cancer has spread to nearby lymph
nodes, it is likely that proton therapy treatment will need to
combined with chemotherapy, and be administered for six toseven weeks.
In comparison with traditional radiation therapy, proton
therapy has fewer side effects on the lung and bone marrow.

10

Treatment period: 2-7 weeks
Pathological and other conditions for proton therapy
nn There are no more than three tumors, and none of the tumors are in contact withthe digestive tract.
nn There are no tumors other than those in the liver.
nn The liver functions are still intact to some extent.

Notes regarding treatment:
The patient may be requested to have a metal marker the size of a mechanicalpencil lead inserted in his or her liver in order to allow the proton beam to beadministered with a higher precision. The procedure to insert such a marker isarranged on the basis of consultation with the patient’s referring doctor anddoctors from the relevant departments of our hospital.

Treatment period: 5-8 weeks
Pathological and other conditions for proton therapy
nn The cancer has not spread to other organs or lymph nodes.
nn Cases of prostate cancer are classified as either low-risk, a medium-risk, or
high-risk according to the condition of the tumor. For cases classified as low-risk,
only proton therapy is administered, and in medium- and high-risk cases proton
therapy is combined with hormone therapy.

Notes regarding treatment:
The patient may be requested to have a metal maker the size of a mechanicalpencil lead inserted in his or her prostate gland in order to allow the proton beam
to be administered with a higher precision. The procedure to insert such a marker
is arranged on the basis of consultation with the patient’s referring doctor anddoctors in the department of urology.

Treatment period: 2-7 weeks
Pathological and other conditions for proton therapy
nn The cancer is non-small cell lung cancer of stage I, II or III and has not spread toany other organs.
nn In cases of stage I lung cancer, proton therapy is provided for patients who do notwish to or are unable to receive surgical treatment for some reason.
nn In cases of stage II or III lung cancer, proton therapy is combined with treatment byanti-cancer medication, in cooperation with the department of respiratory medicine.

Notes regarding treatment:
No smoking is allowed during and after the treatment.
In cases in which chemotherapy is used alongside proton therapy, the patient
may need to be hospitalized.

Esophagus cancer
The most common means of treating esophagus cancer issurgical removal of the tumor. However, in cases in which
surgical procedures incur a high risk due to the age or clinicalcomplications of the patient, radiation therapy combinedwith chemotherapy is a more suitable means of treatment. In
this case, the radiation therapy can be provided in the formof proton therapy. The proton therapy can be effective intreating esophagus cancer while at the same time minimizing
the side effects on other important organs such as the spinal
cord, lungs or heart.

Treatment period: 6-7 weeks
Pathological and other conditions for proton therapy
nn The cancer has not spread to other internal organs.
nn Treatment may take the form of chemoradiotherapy, which is a method combining
proton therapy and anti-cancer medication.
nn Proton therapy is not used in cases in which the cancer has spread to nearby lymph
nodes such that the proton-beam irradiation field cannot fully cover the cancer spread.

Notes regarding treatment:
nn It is necessary for the patient to avoid drinking alcohol for a certain time after
each proton beam administration session.
nn The patient may be requested to have a metal maker the size of a mechanicalpencil lead inserted in his or her esophagus in order to allow the proton beam tobe administered with a higher precision.
nn In cases in which proton therapy is combined with chemotherapy, the treatment
is provided in close cooperation with specialists in internal medicine and surgeryof the digestive organs.

Head and neck cancer
There are a number of types of head and neck cancer. Proton
therapy is currently used for the treatment of nasal cavity
cancer, paranasal sinus cancer, and external auditory canalcancer. It is most often used for the treatment of squamous cell
carcinoma, but can also be administered for the treatment of
adenocarcinoma and malignant melanoma. The actual methodof treatment varies according to the location of the tumor,
results of pathological tissue examinations, and the progress ofthe disease. A multidisciplinary treatment combining surgery,radiation treatment, and chemotherapy may be used for thetreatment of these conditions.

Brain tumor
Brain tumors can be classified as one of two types: primarytumors which occur inside the skull, and metastatic tumors
which have been transferred from other organs. In suspectedcases of brain tumors, diagnosis is carried out using imaging,such as MRI procedures using a contrast dye. In the caseof suspected primary brain tumors, ultimately tumors are
removed by surgery and the removed tissue is examined andused to decide treatment strategies.

Treatment period: 6-7 weeks
Pathological and other conditions for proton therapy
nn The cancer has not spread to other organs.
nn The cancer has not spread to nearby lymph nodes, or, the whole tumor can be
fully covered by a single irradiation field.

Notes regarding treatment:
The possible side effects differ depending on the size of a tumor. A detailed
explanation of such effects will be given as part of consultations regarding
treatment.

Treatment period: 5-6 weeks
Pathological and other conditions for proton therapy
nn Proton therapy may be used to treat primary brain tumors, such as malignant
glioma, and meningioma and schwannoma which are difficult to remove by surgery.
nn Proton therapy is not used to treat metastatic brain tumors because it is possible
to use other radiation therapies.

Notes regarding treatment:
When treating brain tumors with proton therapy, care is taken to ensure that as
far as possible the proton beam is emitted in directions along which it is unlikely
to come into contact with optic nerves or the brain stem. Proton therapy may not
be suitable in some cases depending on the patient’s condition.

Skull base tumor
Skull base tumors occur in the portion of the skull supporting
the brain. These tumors lie deep inside the skull, and in manycases, are attached to or fused with a number of importantnerves or major blood vessels, making surgical treatment
very difficult. Specific examples of such conditions include
chordoma and chondrosarcoma. In some cases, cancer that
occurs in the nasal cavity, paranasal sinus, or eye sockets
may develop into skull base tumors.

Childhood cancer
Children are susceptible to the effects of radiation. Ifchildren receive more than a certain amount of radiationdose, there may be adverse effects on their bone growth,
intellectual development, or endocrine functions. In
some cases, long after the childhood cancer has been
completely cured through radiation therapy, a new cancer,
known as a secondary cancer, may occur, and it is thoughtthat such secondary cancers may be a side-effect of theradiation therapy. Proton therapy can limit the risk of suchcomplications by minimizing the exposure of healthy tissue
to radiation.

Treatment period: 5-6 weeks
Pathological and other conditions for proton therapy
nn Proton therapy is used in cases in which surgery cannot be used or in whichtumors cannot be fully removed by surgery.

Notes regarding treatment:
When treating skull base tumors with proton therapy, care is taken to ensurethat as far as possible the proton beam is emitted in directions along which
it is unlikely to come into contact with optic nerves or the brain stem. As thetreatment is applied to an area containing a dense concentration of importantnerves and organs, a detailed explanation will be given as part of consultations
regarding treatment.

Treatment period: 2-6 weeks
Pathological and other conditions for proton therapy
nn Proton therapy is used to treat childhood solid tumors which need radiation
therapy. We may propose other radiation therapies according to the medical
condition of the patient.

Notes regarding treatment:
As it is necessary to combine this therapy with chemotherapy and surgery, please
consult with your family doctor first.
It is important that therapy is provided at the right timing, so please seek
consultation as soon as possible.

11

Travelling to the Proton Beam Therapy
Center from overseas
Ibaraki

The center can be easily accessed from theairports listed below.
Approximate travel times from each airport to the center by car:

Ibaraki Airport
University ofTsukuba Hospital

80 minTokyo International Airport
70 min(Haneda Airport)
Ibaraki Airport
55 minNarita International Airport

Tokyo

NaritaInternational
AirportTokyo
International
AirportAccess
University of Tsukuba Hospital Bus Stop(“Tsukuba Daigaku Byoin”)
Route 125

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Enokido Intersection

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HitachinoUshiku Station

Tsukuba Medical
Center Hospital
MatsumiPark
Kita Odori Ave.
Saiki Intersection

Kasuga 1-chome
Nishi Intersection
Tsukuba
Expo Center

Tsukuba
StationTsukuba Express

Chuo Dori Ave.
Creo

Tsukuba Center
Bus Terminal(Shoppingmall )

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Midorino Station

Arakawaoki
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Gakuen-Nishi Odori Ave.

SakuraTsuchiura IC

Tsukuba Chuo IC

Yatabe IC

Central Fire
StationM
Av inae. miSasagiIntersection
Banpaku
Kinen Koen
(Park)

Kasuga 1-chome
Bus StopOd

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Tsukuba
StationKenkyu-gakuen
Tsukuba Express
StationKasuga 3-chome Intersection

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Nishi-Hiratsuka
Intersection

Joban
Expressway
JR JobanLine
Tsuchiura
Gakuen Line
Tsuchiura
StationGakuen-Higashi Odori Ave.

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Nishi-Odori
Iriguchi Intersection

University of Tsukuba Hospital
Entrance Bus Stop(“Tsukuba Daigaku Byoin Iriguchi”)

Universityof Tsukuba
Hospital.

TanakaIntersection

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UshikuStationComing to the University ofTsukuba Hospital by car
Exit the Joban Expressway at Sakura-Tsuchiura IC and head for Tsukuba. Turn right at the Sasagi
intersection onto Ibaraki Prefectural Route 55 (Gakuen-Higashi Odori Ave.) toward Shimotsuma.
Turn left at the Saiki intersection onto Gakuen Kita Odori Ave. Turn right at the second traffic light,
then left at the next traffic light, and you will see a sign for the University of Tsukuba Hospital.
Alternatively, exit the Ken-O Expressway (Metropolitan Inter-City Expressway) at Tsukuba Chuo
IC and take Prefectural Route 19 (Science Odori Ave.) toward Kenkyu Gakuen Station. Turn rightat the Ozakai intersection onto Prefectural Route 24 (Tsuchiura Gakuen Line). Turn right at theKasuga 3-chome intersection, and you will see a sign for the University of Tsukuba Hospital.

Coming to the University ofTsukuba Hospital by public transport
Take a train to Tsukuba Station on the Tsukuba Express line. The hospital is a 10-minutes bus ridefrom Tsukuba Station. From Bus Stop No. 6 of the Tsukuba Center Bus Terminal, take a bus on the
University of Tsukuba Loop Line (clockwise direction) or a bus bound for the University of Tsukuba
Central Area (Tsukuba Daigaku Chuo), and get off at the entrance to the University of Tsukuba
Hospital (Tsukuba Daigaku Byoin Iriguchi).
Alternatively, take a train to Tsuchiura Station on the JR Joban line. The hospital is a 45-minutebus ride from Tsuchiura Station. From Bus Stop No. 2 of the Tsuchiura Station West Entrance(Nishi-guchi) Bus Terminal, take a bus bound for the the University of Tsukuba Central Area
(Tsukuba Daigaku Chuo), and get off at the entrance to the University of Tsukuba Hospital(Tsukuba Daigaku Byoin Iriguchi). Alternatively, take a bus to Tsukuba Center and change buses
there, following the directions given above.

Proton Beam Therapy Center,
University of Tsukuba Hospital
Amakubo 2-1-1, Tsukuba City, Ibaraki Prefecture, Japan 305-8576

JR Yamanote Line
JR Keihin Tohoku Line

Tokyo International
Airport(Haneda Airport)

90
min

Tsukuba
University

Nippori
StationTokaido Shinkansen Line

60
min

Tokyo Monorail

Akihabara
Station 45
min
Hamamatsucho
Station
50
min

Tokyo
StationTsukubaExpress Line

Keisei Main Line

Tsukuba Station
Hitachino-Ushiku Station

NaritaExpress Line

NaritaAirportJR Joban LineIt takes around 45 minutes by train from Akihabara Station to the closest station to
the center, Tsukuba Station on the Tsukuba Express line. As central Tokyo is accessible
in around one hour, it is possible to make one-day sightseeing trips to Tokyo from
central Tsukuba City.
For assistance regarding travel from the airport to the hospital, or accommodationor sightseeing arrangements during your stay in Japan, please contact Emergency
Assistance Japan (EAJ), the hospital's designated medical coordination service
company (See page 6 for more information).

http://www.pmrc.tsukuba.ac.jp